Psychotherapy for Kids with Heart Defects

Therapy (or “psychotherapy”) is a powerful tool to help people:

·      Understand themselves

·      Manage thoughts and feelings

·      Learn coping strategies

Therapy can be provided by a psychiatrist, psychiatric nurse, psychologist, social worker, or mental health counselor. It can be in a hospital, school, or private practice. Many therapists offer remote meetings through telehealth. Most therapists cannot prescribe medicines. Psychiatrists and psychiatric nurses can provide therapy and also prescribe medicines.

During therapy, providers and patients use talk and activities to explore feelings, thoughts, and behaviors.  They work on learning ways to feel more successful and reach goals.

Families can find a therapist by asking their doctor, cardiac neurodevelopmental program providers, or insurance company.  They can also look online for therapists in their area. See below for tools to help find a therapist.

It is important to find a therapist who fits well with a person’s goals and needs. Sometimes people try several therapists before they find one who is a good fit.

There are different kinds of therapy. Some therapists use just one type of therapy. Other therapists use a combination of therapy types.

Keep reading to learn some of the types of therapy that can be helpful to many kids with heart defects.

Cognitive-Behavioral Therapy (CBT) helps people understand the connections among their thoughts, feelings, and actions.  During CBT, people learn to:

• Notice unhelpful ways of thinking

• Notice unhelpful ways of acting

• Learn healthier patterns of thinking and acting

CBT is effective for anxiety, depression, eating disorders, and trauma. It can be used with children or adults.  It is not a good choice for people who do not use language or who have trouble understanding abstract ideas.

Exposure Therapy helps people to overcome a pattern of fear or avoidance.  They learn to tolerate something they are scared of little by little. It is effective in treating anxiety, post-traumatic stress disorder (PTSD), panic disorder, and specific phobia.

Exposure therapy can be used with children, teens, and adults.

Family Therapy is a treatment for the whole family system. It helps family members to improve relationships with one another. It can help families to cope with challenges such as behavior challenges, trauma, and coping with mental or physical illness. 

Any combination of family members can participate in family therapy. It can be used with children, teens, and adults.

Group Therapy is offered to groups of people with similar challenges.  One or two therapists lead a group therapy session.

Group therapy can be helpful in treating depression, grief, anxiety, panic disorder, or substance use disorder. It can also help people learn social skills.

Parents of children with heart defects often find it helpful to connect to other parents in group therapy.

Young people with heart defects often find it helpful to connect with others who have the same diagnosis.

Group therapy can be used with children, teens, or adults. It is often not a good choice for people who have personality disorders, who are considering hurting themselves, or who have psychosis.

Mindfulness Therapy helps people be more aware of their thoughts and feelings.  They learn to notice their surroundings, and how they react in their surroundings.

People learn how to:

• pause before acting

• act with intention

• manage their thoughts and feelings

Mindfulness therapy can be a good treatment for anxiety, depression, emotion regulation, and substance use disorder.

Mindfulness-Based Stress Reduction (MBSR) is an especially good choice to treat anxiety and stress.  Mindfulness-Based Cognitive Therapy (MBCT) is an especially good choice to treat depression.

Mindfulness-based therapy may be offered in a group or one-on-one. It can be used with older children, teens, or adults.

Mindfulness-based therapy may not be a good choice for people who do not use much language, or people who have trouble understanding abstract ideas.

Parent-Child Interaction Therapy (PCIT) is a treatment for parents and their children.  It is used to help children who have behavior problems. 

Parents learn to:

1. Create a warm relationship with their child

2. Calmly and confidently manage a child’s most challenging unwanted behaviors

PCIT is used with children ages 2-7 and their primary caregivers. PCIT is not a good choice when the parent has serious mental health concerns.

Mindfulness-based therapy may not be a good choice for people who do not use much language, or people who have trouble understanding abstract ideas.

Parent Guidance is a treatment for parents to help them in managing their children’s challenges.

Therapists can help parents with issues like:

• A child’s unwanted or unsafe behaviors

• Relationships within the family

• Difficulties related to the child’s illness

• A child’s mental health

• A child’s social problems

• A child’s learning

• A family history of trauma

• Family grief

Parent guidance is often best when it is offered alongside therapy for the child. 

Play Therapy helps people to express their thoughts and feelings through games and activities. It is most often used with children, but is sometimes used with adults. Parents often participate in play therapy with their children.

During play therapy, people may play with toys, make art, or play games.

 Play therapy can be helpful in treating trauma, anxiety, and aggression. It can be a good choice for children who have trouble communicating with language.

Psychodynamic Therapy helps people to understand how their unconscious thoughts affect their behavior.

Through psychodynamic therapy people learn to:

• Understand themselves better

• Understand how past experiences affect their feelings, thoughts, and behaviors

 Psychodynamic therapy can effectively treat depression, anxiety, chronic pain, and relationship problems. It can be used with children, teens, and adults. 

Psychodynamic therapy is not a good choice for people who do not use much language. It is not a good choice for people who have trouble understanding abstract ideas.

Unfortunately, some people still feel shame or judgment surrounding therapy and mental health. It is important to remember that seeking therapy does not mean there is anything "wrong" with a person. Instead, getting therapy is just an acknowledgement that people often feel emotions and have thoughts that can be hard to manage.

Your doctor or neurodevelopmental team can help you and your family to identify your therapy needs, and to find a therapist who is a good fit for your child and your family.

Developmental care is best when it is local. Families local to Boston can receive care from the Cardiac Neurodevelopmental Program (CNP), Department of Psychiatry, Department of Developmental Medicine, Social Work, or the Pediatric Advanced Care Team (PACT). Families from other regions can use the link below to find their local care team.